The Art of Nursing : My Take

I feel fortunate to take part in this special Nurse Blog Carnival event. We’re discussing the soul of a great and noble profession. Awesome!

Supreme Court Justice Potter Stewart once famously wrote that he didn’t know how to define a media form relevant to one case, but “I know it when I see it.” Art is like that: hard to fence in or tame with mere words, yet we know it when we see it.

Nursing is no exception. We tend to focus on the science these days, but we also bring our personalities, creativity and intuition to our work. Some of us aim to stick to the official scripts, to do only exactly what we’re trained or ordered to do. “Evidence” is all the rage, ignoring the fact that most health care practices have far less scientific evidence behind them than we imagine, and that corporate interests have increasingly corrupted health sciences for years now. The FDA can’t find scientist/leaders who don’t also work for Pharma: there simply aren’t any. Corruption has become the accepted norm in health science, a lucrative form of advertising. It has long been known that in the most prestigious journals, paid doctors and others scientists claim they write articles actually entirely written by ad firms. Science at its best can’t answer all our questions; in its current state, prescribers do well to wait a few years before offering most new medicines. “Science” leading to FDA approval no longer inspires certainty as to benefits or risks. It offers a ‘maybe’ on both counts; it has become the norm to see abrupt recalls or dire new warnings on medications declared safe a few years earlier. Outright fraud is both banned and permitted.

Where does such a mess leave nurses and patients? Under such conditions, increasingly similar to those a century ago, we can only practice due diligence and muddle along the best we can. In an age of (often reasonable) distrust and cynicism, nurses remain the most trusted profession in America, year after year. We do well to protect this trust, to do everything we can to deserve and earn it anew. Otherwise it won’t last. At our best, nurses offer truly priceless gifts. We guide our patients through the intimidating trial and error process that most treatment entails. We help them figure out how to protect and serve themselves as more savvy and informed customers. Physicians have shown little interest in such work: the prevailing model remains to write scripts and disappear. Yet even if everyone involved were perfect in every way, each treatment would still involve much uncertainty. Each treatment entails a swamp of possible adverse effects mostly impossible to predict: weather predictions remain far more accurate. Think on that! In addition, most treatments may work, or not, or some muddle in between, with no reliable way to predict which will happen. Both sides of the clinical decision coin, both pro and con, offer far fewer easy answers than we’d like. Such is the state of the art, as it now stands. Messy!

The art of nursing – nursing at its best – lies in the countless creative ways nurses help inspire and preserve hope in all this darkness, fear, and confusion. Research strongly suggests that such hope has a strong healing effect all its own (I’ve actually mulled an all-placebo practice from time to time). Without hope, all is lost: motivation, treatment adherence, self-care. You can’t win a battle if you surrender, and hope is all that lies between perseverance and defeat.

The art of nursing lies in finding ways to teach crucial lessons to often weak students: distracted, misinformed, distrustful, confused, even hostile. It lies in motivating people at their worst, easing suffering, rebuilding broken human lives. It lies in juggling a dozen balls while doing all the above, and catching new ones as they (often) get thrown at us without warning. It lies in usually making it all look easy. In holding together the most complex and chaotic health care “system” in human history, one band-aid at a time, day after day, in doing it all so well and often with a smile, nurses practice their art.

You have more power inside than you realize. Let it flow!

The art of nursing is an adventure. Except in a book or on-screen, adventures aren’t always fun. That’s not their nature or purpose. They’re scary, messy affairs, with no promise of success, real danger, and no user’s manuals. Often, they leave you with no easy answers, none at all. Instead, adventures offer a sense of mission: they must be done, risks be damned. They aren’t optional. Nurses & other heroes are like that: they’re on a mission. Life and death: crucially important stuff! Not optional.

Most people avoid adventures. Fair enough, adventures aren’t for everyone: they’re tough! Most folks let someone else carry the load and take the risks. Nurses dive in every day: hence, heroes! Based on federal data, American police officers risk roughly 7 times the average annual risk of violent death. Nurses risk roughly 3 times the average each year, and for far longer careers. One more risk in the mix. Heroes!

We’re in it for the long haul, we’re tough and we’re very good at what we do for humanity. For many and perhaps most of us, the greatest challenge of all is building stamina. To get through a shift or a week is one thing; we aim to keep ourselves going for decades, despite a healthcare system that looks at us like disposable parts, readily replaced. In time, some of us fail physically, others emotionally. We are human, after all. All heroes are human.

The most important art of all for nurses, then, arguably lies in preserving our sanity and will, our strength and health, our ethics and attitudes. Otherwise, we break, rust out, get bitter, lose our way. It happens every day. Some of us limp along in the trenches, and others limp away. Broken.

Don’t doubt it: we can do far better than that. We can support each other, have each others’ backs. We can nurture ourselves. We can do our best, if and when we’re at our best. Maintenance is NOT optional for us: it’s part of our sacred duty. A dull saw is no good to anyone. We dare not accept such dullness of ourselves: we’re too important, our missions are too important, to allow it.

Nurses are heroes. In fairy tales, there’s always the automatic “happily ever after” for heroes. We’re adults, though. We know better. We create our own futures. Who else will do it for us?

Let’s make nurses’ future grand, like we deserve. OK?

Have any ideas or stories of your own? I’d love to hear them! Let’s start a conversation, pool resources…

20 comments

Thank you so much for this fun & insightful post!! I loved it and read it a few times – I love how you capture every essence of our careers – even though we have no user’s manual – we get it done!! You nailed it!! Thanks for sharing!!

I’m glad you liked it. I work in such a narrow slice if nursing, and I’m a rather unusual nurse. I read and interact widely, though: it helps. Unlike so many nurses, I see no value in putting up with crap. It only helps bad actors remain confortable, I believe. But I’m a rabble rouse by nature. Thanks for your kind words – Greg

Nurses are the healthcare leaders that balance preserving hope, promoting healing and providing honest feedback with a healthcare consumer. These three H’s are at the core of the art of nursing: hope, healing and honesty. Your post highlights these essentials, along with encouraging all nurses to support and nurture one another, as well as ourselves, in our professional journey to improve public health.

Thanks for your insightful and honest post about the art and science of nursing. Science has it’s limitations and the art is messy with our human personalities, creativity and intuition! Yet we need both and it is the combination that will help us to provide safe care and experience the privilege of being a nurse as helping or maybe simply being with our patients. The science helps us get there, but it is the art that brings it home and makes it meaningful to ourselves, each other, and our patients.

Greg, I love how your article highlights the many ways we ‘see’ and ‘feel’ the art of nursing every day. Describing it as an adventure, a creative way to teach the distracted, and a ride of hope in the darkest of times- your post surely uplifted me! Thanks for contributing; I appreciate it so much.

The ‘soul’ of nursing- I love it. My favorite line: “The art of nursing – nursing at its best – lies in the countless creative ways nurses help inspire and preserve hope in all this darkness, fear, and confusion.” What a great post, Greg. Thank you so much for being a nurse, a part of this wonderful profession and an advocate for all of us out there. You rock!!

Greg, wonderful, thoughtful post. I agree, nurses are heroes and the Happily Ever After in fairy tales. That’s my story as in the WIP Happily Ever After. I knew I wanted to be a nurse at five-years-old. Christine